初产妇和未产妇的高密度脂蛋白胆固醇浓度的纵向变化与不同的危险因素相关：美国国立卫生研究院生长与健康研究（NGHS）。
Longitudinal changes in HDL-cholesterol concentration are associated with different risk factors in primiparous and nulliparous young women: The NHLBI Growth and Health Study (NGHS).
机构信息
Department of Pathobiology and Molecular Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
出版信息
J Clin Lipidol. 2021 May-Jun;15(3):488-499. doi: 10.1016/j.jacl.2021.03.004. Epub 2021 Mar 17.
BACKGROUND
Previous studies report that first pregnancy is associated with persistent decreases in HDL-cholesterol (HDL-C) concentrations.
OBJECTIVE
This study evaluated factors associated with declines in HDL-C concentration in parous and nulliparous young women.
METHODS
This study leverages data from African-American and white women from the NHLBI Growth and Health Study. Parity-related changes in lipids, BMI and percent body fat were assessed longitudinally. A subset of primiparous and nulliparous women with paired lipid measurements were analyzed regarding changes in HDL-C concentrations.
RESULTS
Among 870 women in longitudinal analyses, African-American women had higher parity (p<0.0001), with baseline measurements of each parity group being similar. HDL-C concentration decreased significantly and remained lower after the first pregnancy, while BMI and percent body fat increased with increasing parity. In the subset of 401 women, HDL-C concentration decreased among primiparous women (-4.81 ± 0.93 mg/dl), with no overall change in nulliparous (p = 0.003). In both groups, greater HDL-C concentration declines were independently associated with higher initial HDL-C concentration and greater increases in BMI (both p<0.0001). Among primiparous women, younger delivery age (p = 0.0001) and birth control use (p = 0.004) were associated with greater HDL-C concentration decline. Nulliparous white women's HDL-C concentration increased over time, with no change in African-American women (p = 0.008); no racial difference was seen in primiparous women.
CONCLUSION
Persistent decreases in HDL-C concentration were associated with the first pregnancy, and were greater with higher initial HDL-C concentration. Racial differences in HDL-C concentration emerged over time in nulliparous women, but not primiparous women. Potential impacts of these findings on women's long-term cardiometabolic health should be evaluated.
背景
先前的研究报告表明，首次妊娠与高密度脂蛋白胆固醇（HDL-C）浓度的持续下降有关。
目的
本研究评估了与经产妇和初产妇年轻女性 HDL-C 浓度下降相关的因素。
方法
本研究利用 NHLBI 生长与健康研究中来自非裔美国人和白人女性的数据。纵向评估与脂类、BMI 和体脂百分比相关的生育变化。对具有配对脂质测量值的初产妇和经产妇亚组进行了 HDL-C 浓度变化的分析。
结果
在 870 名进行纵向分析的女性中，非裔美国女性的生育次数更高（p<0.0001），每个生育组的基线测量值相似。HDL-C 浓度显著下降，并在首次妊娠后保持较低水平，而 BMI 和体脂百分比随着生育次数的增加而增加。在 401 名女性的亚组中，初产妇的 HDL-C 浓度下降（-4.81±0.93mg/dl），而未产者没有总体变化（p=0.003）。在两组中，初始 HDL-C 浓度较高和 BMI 增加更大与 HDL-C 浓度下降幅度更大独立相关（均 p<0.0001）。在初产妇中，较年轻的分娩年龄（p=0.0001）和使用避孕药（p=0.004）与更大的 HDL-C 浓度下降相关。初产妇中，黑人女性的 HDL-C 浓度随时间增加，而白人女性没有变化（p=0.008）；初产妇中没有观察到种族差异。
结论
HDL-C 浓度的持续下降与首次妊娠有关，并且与初始 HDL-C 浓度较高有关。初产妇中，随时间推移，非裔美国女性的 HDL-C 浓度出现差异，而初产妇中没有差异。应评估这些发现对女性长期心脏代谢健康的潜在影响。
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